Why do I drink?

• To relax after a hard day
• To join friends in socializing
• Because you like the taste
• Because it’s an important part of your culture

As with most things we do in life, there are other motivations beneath the surface that shape what we do. Perhaps you drink because:

• Drinking feels like a central way of being close to certain people
• Alcohol has always been part of how you’ve managed
• You feel too bad (lonely, sad, angry, etc.) without drinking
• You’ve tried to stop, but you can’t

There are important reasons why people drink, moderately or otherwise. Notably, for heavy alcohol or drug use, there are likely important psychological reasons why a person uses, to address underlying struggles that others who use may also struggle with. Heavy drinking and/or drug use is often an attempt to help yourself with: problems in relationships; difficulty with self-esteem; challenges in taking care of yourself; and difficulty managing strong emotional states. If you drink or use heavily, you may have started using to fight other problems, but your alcohol or drug use itself may have become a problem of its own

What is of concern is when drinking begins to lead to unwanted consequences. Obviously, you drink because there are things you like about it, or that may have been adaptive for you. But there may also be unwanted consequences that come along with your drinking. Harm is not equivalent to the amount you drink; harm can be caused with lesser amounts, depending on your circumstances. Consider the categories of drinking: Overdrinking, Risky Drinking, Harmful Drinking and Dependent Drinking. Each category describes patterns of drinking that may be worthy of concern.

Overdrinking

There are long-term health consequences for heavy drinking, which is defined by the Substance Abuse and Mental Health Services Administration (SAMHSA)

• liver disease
• heart disease
• sleep disorders
• depression
• stroke
• bleeding from the stomach
• sexually transmitted infections from unsafe sex
• several types of cancer
• difficulties in managing diabetes, high blood pressure, and other conditions

By drinking above recommended limits, the average person will experience unwanted health and social costs. The National Institute on Alcohol Abuse and Alcoholism defines moderate drinking as an average of no more than 1 drink per day (7 per week) for women and 2 drinks per day (14 per week) for men. While those thresholds may sound like small amounts, empirical research shows that above these levels, risk rates begin to climb, putting a person at higher risk for medical, relationship and emotional costs related to drinking.

Risky Drinking

Certain patterns or situations in which you drink may put you at significant risk. Aside from long-term consequences that might develop, there may be more immediate costs. Risky drinking includes the following:

• Drinking alcohol when you have had problems with alcohol use in the past
• Drinking while driving, riding a bicycle or engaging in potentially dangerous work
• Binge drinking – typically defined as reaching a blood alcohol level of 0.08% or above, generally equivalent to a male drinking 5 or more drinks or a female consuming 4 or more drinks within a two-hour period.
• Speed drinking – a form of binge drinking, speed drinking involves drinking rapidly and competitively and leads to consumption of large amounts of alcohol in short time periods, often with a sudden onset of intoxication well beyond what was expected
• Drinking when you have a health condition that is worsened by alcohol use (such as a peptic ulcer, hepatitis, clinical depression or anxiety)

Harmful Drinking

Aside from assessing how much you drink, or considering risky situations in which you drink, ask yourself whether alcohol may be causing problems for you or the people around you. Harmful drinking is the continued use of drinking despite negative consequences, including problems related to alcohol in relationships, work, school, finances, your mood and your health. Perhaps someone has expressed concern to you about your drinking. Maybe you drive buzzed. You may spend mornings recovering from a hangover. Statistics on negative outcomes associated with drinking:

• Alcohol is a factor in about 60% of fatal burn injuries, drownings, and homicides;
• 50% of sexual assaults and severe trauma injuries involve alcohol; and
• 40% of fatal motor vehicle crashes, suicides, and fatal falls involve alcohol.

Dependent Drinking

Even people who are alcohol dependent may function quite well in their life, with their dependence on alcohol hidden from view. Some high functioning professionals are alcohol-dependent, but no one would suspect it, because they may not fit narrow stereotypes for the chaotic alcoholic often depicted in the media. While dependent drinking may include physiological dependence and high tolerance, it more generally refers to alcohol increasingly taking over your life, with more money and time spent on alcohol use, as well as recovery from it. You may drink every night before falling asleep. You may rely on alcohol as part of socializing. You may have been arrested for driving under the influence of alcohol. You may have lost relationships because of your drinking. (Adapted from Miller and Munoz, p. 3-7)